JO

RG
BU

NON-EXHIBITING DELEGATE(S)
REGISTRATION FORM

we deliver meetings
2-4 NOVEMBER 2016
SANDTON CONVENTION CENTRE
JOHANNESBURG, SOUTH AFRICA

www.discopafrica.com

Form must be completed, signed and faxed to +1 323 782 1301 or emailed to registration@basiclead.com

REGISTRATION OPTIONS
Visitor
US$ 400

Content
Buyer
US$ 250

Content
Producer
US$ 250

Influencer
US$ 400

Non-Exhibiting Seller
US$ 1,000

All-access pass to the 3-day market

4
4
4

4
4
Discounted hotel rates
4
4
4
4
Access to the conference
4
4
4
4
Matchmaking/Meeting organization assistance
4
4
4

4
4
4
4
4

4
4
Access to producer list + contacts in advance
4
4
Access to visitor list + contacts in advance
4
4
Access to investor list + contacts in advance
4
4
Access to buyer list + contacts in advance
4
4
Content featured on DISCOPAfrica.com (up to 10 titles)
4
Access to Pitching Competition
4
Access to the workshop program
4
4
4
4

4
4
4
4
4
4

Invitation to all public social events

4
4
4

before/during the market

Access to seller contact details in advances

4
4
4
4

COMPANY INFORMATION
COMPANY NAME________________________________________________________________________________________________
COMPANY MAILING ADDRESS_____________________________________________________________________________________
CITY____________________________________________ ZIP CODE________________________ COUNTRY____________________
MAIN TEL________________________________________MAIN FAX_________________________ WEBSITE_____________________
FACEBOOK_______________________________________TWITTER______________________________________________________

COMPANY ACTIVITY
ADVERTISER

EXPERT

PUBLIC BROADCASTER

ADVERTISING AGENCY

FILM PRODUCER

PUBLIC ORGANIZATION

AIRLINE

FINANCIAL INSTITUTION

SATELLITE DISTRIBUTION PLATFORM

BROADCASTING SERVICES

INTERNET DISTRIBUTION PLATFORM

TALENT AGENCY

CABLE DISTRIBUTION PLATFORM

MEDIA BUYING AGENCY

TELCO

CLOSED CIRCUIT

MOBILE DISTRIBUTION PLATFORM

THEMATIC TV CHANEL

CONTENT DISTRIBUTION / INTERNATIONAL

MOVIE THEATERS

TV CONTENT PRODUCER

CONTENT DISTRIBUTION / NATIONAL CONTENT

POST-PRODUCTION SERVICES

VOD OPERATOR

DISTRIBUTION / REGIONAL

PRIVATE BROADCASTER

WEB CONTENT PRODUCER

DUBBING SERVICES

PRODUCTION SERVICES

OTHER :_________________

BUY / SELL / PRODUCE

Check all that apply
BUY

SELL PRODUCE

BUY

SELL PRODUCE

ADAPTATION RIGHTS / SCRIPTED

THEMATIC CHANNELS

ADAPTATION RIGHTS / UNSCRIPTED

TV PROGRAM PROJECT

BROADCASTING SOLUTIONS

TV PROGRAMS

CREATIVE SOLUTIONS

WEB PROGRAM PROJECT

FEATURE FILM PROJECT

WEB PROGRAMS

FUNDING SOLUTIONS

OTHER :________________

TECHNOLOGICAL SOLUTIONS

USA: 6399 Wilshire Boulevard Suite 511 Los Angeles, CA 90048

TEL +1 323 782 1300 FAX +1 323 782 1301
sales@basiclead.com

Page 1 of 2

JO

RG
BU

we deliver meetings
2-4 NOVEMBER 2016
SANDTON CONVENTION CENTRE
JOHANNESBURG, SOUTH AFRICA

NON-EXHIBITING DELEGATE(S)
REGISTRATION FORM
www.discopafrica.com

Form must be completed, signed and faxed to +1 323 782 1301 or emailed to registration@basiclead.com

PARTICIPANT 1
MRS. MS. MR.
FIRST NAME ______________________________________LAST NAME ______________________________________________________
JOB TITLE_________________________________________EMAIL ADDRESS__________________________________________________
DIRECT TEL_______________________________________MOBILE__________________________________________________________
FACEBOOK________________________________________TWITTER________________________________________________________
REGISTER AS: BUYER

NON-EXHIBITING SELLER

VISITOR

PRODUCER

INFLUENCER

PARTICIPANT 2
MRS. MS. MR.
FIRST NAME ______________________________________LAST NAME ______________________________________________________
JOB TITLE_________________________________________EMAIL ADDRESS__________________________________________________
DIRECT TEL_______________________________________MOBILE__________________________________________________________
FACEBOOK________________________________________TWITTER________________________________________________________
REGISTER AS: BUYER

NON-EXHIBITING SELLER

VISITOR

PRODUCER

INFLUENCER

TERMS AND CONDITIONS

This registration form is a contract of participation.
Payments are due within 5 (five) business days upon receipt of the invoice and if payment is not received, registration is subject to
cancellation. New registrations will reflect current registration prices.
Should you not be able to attend, please inform us via email at registration@basiclead.com.
All registration purchases are final and non-refundable. Registrations cancelled on or before October 18, 2016 will be entitled to a full credit
for a future DISCOP market. Registrations cancelled after October 18, 2016 will NOT be entitled to a credit.
Substitutions can be made. If you wish to substitute a participant (transfer registration to another participant), email us at registration@basiclead.com
by October 18, 2016. No substitutions after October 18, 2016. Substitutions are irreversible.
By attending DISCOP Africa you acknowledge and agree to grant BASIC LEAD the right at the event to record, film, photograph, or capture
your likeness in any media for promotional and marketing efforts.
As a registered participant, you allow BASIC LEAD to use your contact info in DISCOP Africa participant list, Matchmaking Services
(AKA Meeting Organization Services) and to receive information from DISCOP events and/or BASIC LEAD events.

ORDER CONFIRMATION
GRAND TOTAL DUE

US$___________

Please include your discount code in the PROMOTIONAL CODE section below, if you have received a special offer. For more information on current
promotions, go to www.discopafrica.com.

PROMOTIONAL CODE

I, (Print Name)______________________________ understand

and accept contract with terms and conditions described
above.
Date: _______ / _______ / _______
Signature and/or Stamp

USA: 6399 Wilshire Boulevard Suite 511 Los Angeles, CA 90048

TEL +1 323 782 1300 FAX +1 323 782 1301
sales@basiclead.com

Page 2 of 2